HomeMy Public PortalAbout4821 CLOVERLY AVE_Mechanical__ 76A364 - CE818 - 3-69
APPLICATION FOR PERMIT
HEATING - VENTILATING - AIR CONDITIONING
COUNTY OF LOS ANGELES 7NEAREST
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DEPARTMENT OF COUNTY ENGINEER �/
BUILDING AND SAFETY DIVISION
JOHN A LAMBIE COUNTY ENGINEER 7 ,ji ale
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COLEMAN W JENKINS,SUPERINTENDENT OF BUILDING L �7
FOR APPLICANT TO FILL IN - OWNER
(PRINT OR TYPE ONLY)
MAIL
NO TYPE OF APPLIANCE OR EQUIPMENT FEE ADDRESS g,2 ) C`a ✓Q� per//
ABSORPTION SYSTEM BTU CITY 7eAll le �/' TEL NO L(J C1, 2-3
CONTRACTOR
AIR HANDLING UNIT, CFM
ADDRESS
BOILER, HORSEPOWER
CITY TEL NO
COMPRESSOR, HORSEPOWER STATE LIC
LICENSE NO CLASS
VENTILATION SYSTEM DISTRICT NO GROUP ZONECESSED BY
EVAPORATIVE COOLER �rfiyl t�-
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FURNACE FAU GRAVITY
INSPECTION RECORD
FLOOR BTU
HEATER SUSPENDED UNIT
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NEW- ADDITION PERMIT $ 3 00 N
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ALTER JLREPAIR_ TOTAL FEE $
PLAN CHECK APPLICANT
NAME & /-o N'D
ADDRESS Zzp uc- Cl V-e{�
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CITY lem&i / TEL NOZrz f 2 3
IHEREBY A KNOWLEDGE TAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING HEATING VENTI- APPROVALS DATE INSPECTOR'S SIGNATURE °
LATING AIR CONDITIONING
IHEREBY CERTIFY THAT I AM W ACTING IN VIOLATION OF ROUGH 17- o„
CHAPTER 9 DIVISION THE INESS AND PROFESSIONAL FINAL 'i
CODE OF THE STATE F AL F /
SIGNATURE /1 JACK R ALLEN, SUPER DISIMECHANICAL ENG'R
OF PERMITTEE n (GG.///1✓✓/
PERMIT VALIDATION M O CASH
PLAN CHECK VALIDATION
I Ar- 5 6 5 5 c JUL 1 A 1 D 7.0 0� Q
Y
SEE BACK OF APPLICATION FOR COMPLETE FEE SCHEDULE